Training staff where patients usually present should improve detection and advice

The UK government announced at the end of last year that £3.2m (€4.8m; $6m) was to be made available “for new initiatives which will help identify and intervene early with” people who may be damaging themselves with alcohol.1 In 2004 in England 38% of men and 16% of women aged 16-64 had an alcohol use disorder (26% overall), equivalent to around 8.2 million people.2

About £217m is currently spent on specialist alcohol treatment, but compare that with the £20bn estimated cost of alcohol misuse. We hope that some of the new money will be used to support those clinical settings in which alcohol misuse is common and detection and intervention are most likely to be rewarding—for example, in hospital emergency departments, general practices, and hospital wards.

Most conurbations in England have one or more specialist alcohol units, which are usually headed by psychiatrists and largely deal with complex problems such as dependence, psychiatric comorbidity, and accompanying physical illness. These are controlled …